Gastrointestinal Bleeding: Prevalence, Etiology, and Outcomes in COVID-19 Inpatients

The current study aimed to investigate the prevalence, risk factors, endoscopic findings, and outcome of gastrointestinal bleeding in COVID-19 hospitalized patients.

This study is a retrospective review of COVID-19 hospitalized patients with gastrointestinal bleeding from a large university hospital in southeast Iran. This study was conducted over one year from April 2020 to March 2021.

Out of 3563 COVID-19 inpatients with approximately equal sex distribution (52.5% of men and 47.5% of women), 80 (2.24%) patients with a mean age of 58.01 ± 20.71 were identified with signs of gastrointestinal bleeding, including; melena (48.8%), hemoglobin drop (42.5%), fresh blood hematemesis (31.3%), rectorrhagia (20%) and coffee ground emesis (10%). 52 patients (65%) had signs of gastrointestinal bleeding on admission, and 28 patients (35%) developed gastrointestinal bleeding during their hospital admissions, most of whom were men (63.8%). Endoscopic characteristics were; gastric erosion (27.7%), gastric ulcer (23%), duodenal ulcer (21.5%), esophageal ulcer (12.3%), and esophageal erosion (6.1%) in upper gastrointestinal endoscopy. On colonoscopy, hemorrhoids (25%), mass lesions (16%), fissures (8.3%), diverticular lesions (8.3%), and polyps (8.3%) were the most common findings. The overall mortality of the patients in the present study was 36.2%. However, gastrointestinal bleedingrelated deaths were 7.5%.

Gastrointestinal bleeding was identified in 2.24% of hospitalized COVID-19 patients, with gastroduodenal ulcers and erosions as the most common symptoms.